POSITIVE PANIC ATTACK BLOG

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What Are Panic Attacks

Everyone knows what panic feels like, and it is common to feel a bit panicky every now and again.

A child runs out in front of your car and you nearly hit them.

You’re sitting an exam paper and you realize that you don’t know any answers to the questions.

Your go to pay for something and discover your purse has been stolen.

Your car breaks down on a country lane in the evening and you do not have a mobile phone.

It would be understandable in any of the above circumstances to feel a sense of panic. This would be perfectly normal and it would pass after a while.

A panic attack is a bit like ‘normal panic’, but it’s different in two main ways

The feelings are a lot stronger and there is usually a sensation of anxiety and impending doom.

The feelings seem to come ‘out of the blue’ and are not usually related to the above frightening situations.

As the feelings are unexpected and strong they can feel extremely scary.

Panic attacks affect people in different ways. From personal experience I can vouch there is always a frightening feeling that something really bad is going to happen.

As someone who has suffered hundreds of panic attacks the truth is –

NOTHING AWFUL IS GOING TO HAPPEN AS PANIC ATTACKS ARE NOT DANGEROUS. NOBODY HAS EVER DIED OF A PANIC ATTACK

There is no shame in having a panic attack. Lots of people suffer from them, although the symptoms can be different from each person. Some people suffer from them for many years whilst others have them only once. Some people have a panic attack every day (like I use to), others only have them once in a while.

If you were to ask your friends and family if they have ever had a panic attack it is very likely at least one or two would have experienced a panic attack. In fact it’s estimated that 1 in 3 people have experienced at least one panic attack. They are quite common and are not a sign of serious mental illness – mental or physical. I view panic attacks as just a bad habit.

Some non-serious physical conditions can cause symptoms which are similar to panic attacks. These include-

Drinking too much caffeine or alcohol

Over-active thyroid. (I remember when I went to doctor with my initial symptoms they did a blood test for this. Unfortunately I did not have this as recovery would have been a lot easier!)

I’m just an average guy who suffered panic attacks for any years. I worked out how to recover and overcome them but I can’t claim to have any medical knowledge. If you think your symptoms have a physical cause then please go and get it checked out by your doctor. However if they say it's stress, anxiety or panic attacks then PLEASE BELIEVE THEM. ONE OF THE COMMONEST CAUSES OF A DELAY IN RECOVERY IS THE PERSON SEARCHING FOR A PHYSICAL DESEASE TO MATCH THEIR SYMPTOMS; INSTEAD YOU SHOULD ACCEPT THE DIAGNOSIS.

I thought I had in various stages, a heart problem, brain tumour, Multiple sclerosis, Mad cow disease…..etc…..etc. It’s embarrassing and laughable looking back now. It wasn’t at the time though.

SUMMARY: Panic Attacks are very common. They are not a sign of serious mental or physical illness. If your doctor diagnoses you with anxiety or panic attacks please accept this this.

The below article will help cope, reduce and eliminate panic attacks. If you wish to read my free eBook on to Cure and Recover from Panic Attacks then please fill in the box below. Also my Blog has lots of resourceful articles on anxiety and panic attacks, or alternatively you can use the search box to find something more specific.

This article will teach you to -

Recognize if you’re having panic attacks

Understand that the causes of panic and why it's keeps going

Accept panic attacks cannot hurt you

Learn tools and techniques to overcome this

RECOGNISE PANIC – How Do I Know If I’m Having Panic Attacks?

It may seem obvious if you’re having a panic attack, but it’s not. Panic attacks feel so terrifying and come so ‘out of the blue’, that people can’t quite believe that it’s only a panic attack. They often presume it’s something far more serious. The feeling of panic attacks can be so unusual that you probably won’t even realize what it is. In my case there was a more gradual decline into recurring panic attacks. They started with me feeling peculiar for short periods of time, and then over a period of several months they started to become full blown panic attacks with horrible anxiety.

One of the first and probably most important steps in overcoming panic attacks is recognizing that your symptoms are caused by panic disorder.

Panic affects affect how you think, how your body reacts and how you behave. We all experience different symptoms as we are all unique. Below are some of the most common symptoms. You may be experiencing all, or some of them.

SOME COMMON SYMPTOMS OF PANIC ATTACKS

- Heart Pounding

- Heart seeming to stop, then a missed or skipped beat.

- Chest pains

- Changes in breathing – breathing too fast, feeling like you can’t get enough air

- Feeling faint, wobbly legs

- Tension around the head, headaches

- Numbness or tingling in fingers, toes or lips.

- SENSITIVITY TO LIGHT OR EYE ISSUES – I would find using computer, TV or even reading would trigger panic attacks.

FRIGHTENING FEELINGS SUCH AS

- Feeling anxious in situations where you have felt panic before

- Feeling utter terror

- Feeling like your outside your body, a sense of unreality (personally I never experienced this one)

FRIGHTENING THOUGHTS FOR EXAMPLE

"I’ve got to escape from here"

"I’m going to have a panic attack and make a complete fool of myself"

"I’m losing control of myself"

"I’m going to be sick"

"I’m choking"

"I’m going crazy"

"I can’t Breathe"

"I will collapse or faint in a minute"

"I’m going to have heart attack"

REMEMBER: NONE OF THE ABOVE WILL EVER ACTUALLY HAPPEN, BUT PEOPLE THINK THEY WILL

SO HOW DOES THE ABOVE CHANGE OUR BEHAVIOUR –

YOU AVOID situations that cause you to panic or may cause you to panic. For example you avoid shopping in a busy supermarket.

YOU ESCAPE as soon as you can when you feel the panic progressively getting stronger. Usually there is a threshold when you feel you cannot stand it any longer and you runaway. For example in the supermarket you rush around get your groceries and escape through the checkout as fast as you can.

PREVENT what you think is going to happen by having coping strategies to make yourself safe. For example if you feel faint you sit down, if your legs go wobbly in the supermarket you lean on a trolley, if you feel suffocated you start breathing more rapidly, If you think you’re having a heart attack you lie down or scan your body if you think something is wrong. These are often called Safety Behaviours.

FIND HELP - Research has shown a quarter of people who experience their first panic attack called an ambulance or end up in A&E. They were convinced something terrible was going to happen to them.

After I suffered continuous panic attacks and heart palpitations I visited A&E and of course it was a complete waste of time, as they dismissed my condition as stress. Have you done this or seen your doctor because of panic attacks?

COPING STRATEGIES - People often cope by avoiding their fears or facing them up to a point before they become too anxious. Others may have been told that certain things like relaxing or distraction is helpful.

ALL THE ABOVE CAN HELP STOP A PANIC ATTACK, THEY ARE ALSO PART OF THE PROBLEM

If you recognize yourself in the above thoughts, feelings and behaviours then it’s likely you are suffering from panic attacks and anxiety.

SUMMARY so far in recognizing if you are suffering from panic attacks…………..

A panic attack is a strong sensation of fear and terror that comes on very suddenly. Physical symptoms include wobbly legs, feeling faint, pounding heart and heart palpitations, shaking, fast breathing, eye focusing problems, etc. People often get frightening thoughts especially after having reoccurring panic attacks. They presume something awful will happen. A coping technique is to escape or avoid the fear.

The panic symptoms described is just fear in it's extreme form. The body is trying to tell you run away or fight your way out of trouble. The problem is when you’re stuck in a supermarket, you don’t want to do either. Fear is being activated because your mind is perceiving there is a threat whether this is intentional or not. Fear can range from mild anxiety, which is helpful when you need to raise your game. For example before an important football game. Through to a full blown panic which is utterly debilitating.

But what is the purpose of fear if it is so unpleasant. Well, it’s a bit like pain. If you were to break your arm your body would warn you through pain not to pick anything up as it may do more damage. If you were to walk down a dark alley way and you heard a noise behind you, your body would respond with fear. By doing this it’s warning you that you may have to deal with a dangerous situation. Fear is in fact trying to help you. It’s preparing you for action.

This preparation is often called the ‘freeze, flight or fight’ response. The fight or fight response is your body getting you ‘revved up’ to either run away or fight as described above in the supermarket. The other option is your body may just freeze with fear and wait for the threat to pass. I once remember being frozen with panic in B&Q. I did somehow manage to make it out of the shop!

So if we take the example of the alleyway. If you turned around and there was a mugger in front of you may just freeze. The mugger may then just take your handbag and that’s the end of it. Or you may be faced with fighting for your life or the handbag. The last option is you may just want to run from him to get away. Your fear response would help with any of these.

When we are frightened –

Our bodies want to take in more oxygen for our muscles

Your heart beats faster to get the blood pumping

Your digestive system closes down to concentrate on more important things

And other changes take place

These body reactions are perfectly normal and healthy, and are there to help you. It’s nothing more than your bodies alarm system.

The problem with people who suffer reoccurring panic attacks is that there is no reoccurring physical threat. Your body is acting like a lion is about to jump on top of you and eat you. However because there is no real threat it’s really a false alarm.

Panic attacks are a bit like an annoying smoke detector which goes off at the wrong times because it’s too sensitive. Or think of a car alarm triggered by the wind, or the burglar alarm triggered by a cat. These are example of alarms which can be set off where there is no real danger. The same can be said for your bodies ‘alarm system’. It’s triggering for no real reason and it's causing you a living nightmare.

The problem we have today is our bodies alarm system was designed many thousands of years ago, when we faced real physical threats to our danger every day. We are now very rarely faced with life or death threats that our ancestors were – others tribes, prehistoric animals, etc. We have very different threats today mainly related to stress –

-Divorce

-Moving house

-Overworking

-Bereavement

-Health worries

-Financial worries

-Family problems

All the above are stressful and can raise our stress levels to a point where the ‘alarm system’ is triggered.

Think of stress as a thermometer, when the stress levels raise it results in a panic attack. Whilst a panic attack is terrifying, frightening and debilitating, it’s not dangerous. A PANIC ATTACK CANNOT HARM YOU. It’s a process which is designed to protect us, not harm us.

SUMMARY: Hopefully you understand that now –

Panic is basically fear. It’s our bodies alarm telling us there is a threat. It prepares are body to either run or fight from danger, but as there is no physical danger it’s a false alarm. Our threats nowadays tend to be more psychological.

As mentioned above, stressful events cause anxiety levels to rise. This isn’t too much of problem in the short term, but over a longer periods stress can trigger panic attacks. Have you had any prolonged period of stress? Has work been stressful, relationship issues, loss of a loved one or financial difficulties.

Health worries

Panic attacks often start when a person becomes over concerned with their body and health. There can be many reasons for this. If you experience the sudden death or a close friend, then you can become more focused on your own mortality. You can become more concerned about little signs signalling that you may be developing an illness. It’s quite easy to read stories of medical mistakes where an illness has not been identified. Therefore the person goes from doctor to doctor checking their symptoms to make sure money is seriously wrong. As a result anxiety levels rise.

A person's logical thoughts conclude (understandably) that’s these anxiety symptoms are evidence of a horrible illness which results is panic. If you think back to when your panic attacks began, do you remember anyone who died suddenly that you knew. This may have been from a heart attack, brain haemorrhage or stroke. Or maybe you read or watched something that got you thinking about illness or death.

Health related reasons

Panic can manifest itself for the first time during a period of ill health. Some viruses can cause dizziness which can be interpreted as something far worse. Pregnancy or the menopause changes the hormones levels in a women’s body. The bodies’ chemistry alters and this can lead to a first experience with panic attacks.

Diet

Related to health but deserves it's own category. Our diet has changed dramatically over the last 100yrs. Sugar, salt, preservatives, etc. are now common place in our diets. Our diets alone can cause panic attacks. It’s important to eat healthy and provide your body with nutritional food. Low blood sugar levels can trigger panic attacks as well as stimulants like caffeine and alcohol.

Bottling emotions

Panic attacks often begin when feelings are bottled up and tension builds inside. Maybe you have some sort of relationship problem? Difficult emotions from the past can add to the problem but it’s important to know constantly dwelling over the past is not going help you now. Constantly searching in the past for issues that may be causing problems in the present is not going to help. Quite often (as I did) my panic attacks were my secret and I hardly told anyone how I was feeling. So it is important that you have a network of friends you can share and offload problems. But your recovery lies in applying tools and techniques in the present, rather than going over old ground trying to identify past things that may have triggered it.

Out of the blue

Sometimes it’s difficult to know why panic attacks start. Some people have their first panic attack when their fast asleep. It may be a combination of factors coming to together and that’s enough to trigger the car alarm. There is no danger but the body has just reached a threshold which causes a panic attack.

It’s really less important to know what caused the panic attack and more important to know what is keeping the cycle of fear and panic alive.

Why do panic attacks keep happening?

Fear and panic affect your body, thoughts and behaviour. Essentially all three work together to keep panic going.

Body

Firstly physical symptoms make the problem worse. For example if you’re too tense you are not going to be able to relax. If anxiety is causing you to breathe quickly or make you feel like you’re not breathing enough, you’re going to hyperventilate. Hyperventilation just means over breathing – your taking in too much oxygen. It’s harmless but causes feelings of dizziness, and is often taken as further evidence something is wrong with you.

Thoughts

Secondly, the anxious thoughts cause physical symptoms and this forms a vicious cycle that keeps panic attacks coming back again and again. This is really important and recovery is really only fully complete when you can re-train your mind to think positively again. Also focusing on every heartbeat or hot flush can make these everyday sensations become a threat.

People with panic attacks often worry about their physical sensation and interpret them to mean something different to what they really do. Some of the common misinterpretations are:

What you Feel

Actual Reason this is Happening

Common Fear

Heart thumping in chest

Chest Pains

Adrenaline being pumped around system.

Muscles tighten ready for action

I’m having a heart attack

Eyes go funny

Feeling unreal

Tunnel vision

Eyes try to focus on danger in hand

Going mad, something bad is going to happen

Faster breathing

Preparing body to run or fight

Can’t get enough air

Head feeling tight

Tensing of muscles/extra blood flow to main organs

Brain tumour/hemorrhage

Tingling in fingers and lips

Blood diverted to muscles ready for action

Stroke or Heart Attack

People often find it hard to believe thoughts can be responsible for all these nasty sensations. But it’s true, and unless the person believes this it delays recovery. Our thoughts become so instinctive and habitual after a while, and so engrained in our subconscious that we often don’t realize what we’re thinking. This is why I advocate if you’re suffering from panic attacks that you have a piece of paper ready when you have an attack to write down exactly what you’re fearful thoughts are.

If you think about it, if you believe something 100%, then you will feel exactly the same way as if it’s true.

Your thoughts can also affect panic by making a person worry that they will have a panic attack where they panicked before. This becomes a self-fulfilling prophecy as it's makes it much more likely it will happen, and leads to the person avoiding the situation.

Behaviour

Lastly, how a person behaves before, during and after a panic attack has a major part to play in whether panic attacks keep reoccurring. The safety behaviour, avoidance and escape as described earlier ads to the cycle of fear.

The vicious circle of panic attacks

The physical symptoms, behaviours and thoughts form a vicious circle which keeps the panic attacks continuing over time.

TO SUMMARIZE

Fear is actually helpful (in the correct circumstances) it's preparing our bodies to run or fight

Panic attacks start for a number of reasons

-Stress

-Out of the blue

-Health worries

-Bottling up emotions

-During an illness

The cycle of panic attacks keep going because of a vicious circle of

-Behaviour

-Thoughts

-Physical symptoms

By avoiding, Running away or trying to prevent the panic attack (in other words you fear it) you may

-lose confidence in your ability to cope

-never find out that nothing horrible is going to happen

-dread returning to the situation as you fear another attack

Can you die from a panic attack?

No you can’t. Hopefully you now understand and recognize a panic attack. By having the knowledge to fully realize what a panic attack is, you can now accept a panic attack is not harmful to you in anyway. Apart from making you feel frightened and then physically drained afterwards. As Dr Claire Weekes stated, if you can accept and float past your panic attacks then you have come a long way to overcoming them.

SUMMARYA Panic attack can never hurt you

How to cope with panic attacks – Tools and techniques to reduce and cure panic attacks

I can assure you panic attacks are perfectly treatable – I’m testimony to that! Knowing that panic attacks are not harmful may simply be enough to take the sting out of them. However if you have been experiencing panic attacks for a while this is rarely enough to stop them.

As we have seen panic attacks affect your mind, body and behaviour. It’s logical to try and break these down and treat each one. Each of us are unique so different techniques will be more helpful than others. Nobody finds the same things helpful. In my experience success is not overnight. Each technique takes time to master to see any real benefit. You have to stick at it and persevere and you will see benefits.

The two main things that will help with the physical symptoms are

Relaxation

Controlled breathing

Panic attack techniques are helpful for a number of reasons -

Learning to relax and breathe properly is the opposite of panic.

Panic attacks often are triggered by a stressful period. By applying these tools you can lower stress and anxiety.

When you learn to not to escape, techniques can help you to cope and recover.

They can "stop panic in it's tracks" blocking the cycle of fear that leads to full blown panic attack, by preventing hyperventilation and lowering anxiety symptoms.

I would always recommend that you practice the below techniques when you not anxious. View it as training before the event. An Olympic athlete would not just turn up and hope for the best. He/she would have trained for a long time to succeed.

RELAXATION

We all relax in different ways. A good place to start is your lifestyle. What do you do to relax? I think it’s a good idea to draw on a piece of paper you in the middle and draw lines (spider diagram) to things you enjoy doing to relax. For example, hot bath, reading, walking, swimming, artwork, fishing, etc. As well as finding everyday ways to relax from the stresses of work, family life, etc. There are special relaxation techniques you can use which can help control panic attacks.

One of the worst things about panic attacks that I experienced was the tensing of the muscles which make physical symptoms worse, and reduce deep breathing. To stop this you must recognize that you’re doing it and make an effort to relax your muscles. My advice here is to stop what you’re doing and make the effort to properly relax for several minutes. I encourage that you have several relaxations tools (long and short) so that whatever situation you’re in you can practice relaxation. For example if you’re at work you can probably practice a 5 minute relaxation easily, but not a 30 minute lie-down full body relation meditation.

Full relaxation is different from just sitting down with a cup of tea and watching Eastenders. There is a place for this but really it requires properly switching off. This can only be learnt through practice. Like any skill it has to be learnt.

There are cd's or MP3 downloads which I would recommend and are extremely useful to guide you to a deep relaxed state. They have the advantage of teaching you to go through the main muscles groups in your body and learning to tense and relax muscles.

Yoga and meditation classes can also be a good way to acquire the skills required.

REMEMBER – Relaxation techniques help to reduce the strength of a panic attack but they do not prevent anything awful happening. THAT’S BECAUSE NOTHING AWFUL IS GOING TO HAPPEN.

BREATHING

When you become scared we breathe faster, so that oxygen is pumped around more quickly. However as we are not running or fighting away out of trouble breathing too fast, irregularly or shallowly can lead to horrible sensations. When were stuck in a lift, Shopping centre, on the motorway (or whatever makes you afraid) we do not want our bodies to prepare us for action. So by not burning energy the extra breathing we are doing creates sensations such as tingling, dizziness and faintness. If you can control your breathing then you stand a better chance of reducing your symptoms. This all adds up to helping to break the vicious cycle of fear.

Breathing properly involves breathing deeply from the belly or abdomen and slowly. My breathing for any years was not very good. I would breathe from my chest, very fast. It wasn’t helped by my posture either. As we progress through life we pick up bad habits, so it’s worth re-educating yourself on the correct way to breathe. It may sound silly but it’s an important part of recovery. If you don’t believe me look at a baby breathing and see how slow and relaxed it breathes. Sometimes it’s hard to notice that there even breathing at all.

If you can calmly and slowly bring your breathing under control for a few minutes then this will help reduce the frightening sensations. This is not as easy as it sounds. If you’re having a panic attack trying to bring your breathing under control can be very difficult. By the way when I say control, I don’t mean trying to whip your body into action to breathe the way you want it. It’s the complete opposite – you have to let go and let your body become as loose as floppy as possible. Then you can begin to get deep, slow breaths.

One of the effects of having a panic attacks is that it makes you feel like gulping more air. Therefore you know this is the wrong thing to do, but it’s difficult to fight against it when your whole body is telling you to do it.

The key lies with practicing this when you’re not panicking. You will only see the benefits when you practice and you apply it when you feel less anxious. It also works much better in the early stages of a panic attacks. Just remember to practice and more practice, and apply and stick with it during an attack.

From my experience if you learn to relax and apply other techniques at Positive Panic Attacks your breathing will naturally calm down anyway. The other problem with trying to take over your breathing is once the panic attack reaches a certain level, it’s very difficult to do anything let alone control your breathing.

A basic guide to breathing

Fill your lungs with air being relaxed as possible. Imagine you stomach as a balloon and you want to fill it up with air. It should expand so your belly button pushes outwards. Do not breathe in a shallow way, using your chest. Keep your breathing slow and calm. Breathe in through your nose and out through your mouth.

Breathe in slowly for 4 seconds. Sometimes it helps to put a word in between to make sure you breathe in for 4 seconds.

Remember: if you choose not to do anything at all you may hyperventilate but nothing disastrous is going to happen to you.

THE MIND

There are 4 common things that you can do to stop your mind adding fear to the panic cycle.

Question, challenge and test you frightening thoughts.

Distract yourself so that your thought processes go down a different route.

Try to work out what is making you tense and change your perception of it.

Stop Focusing on your Body

Stop focusing on your body and thinking negative thoughts

Try to notice if you’re scanning your body for problems or you’re focusing on symptoms. This is only going to make the fear far worse and should be avoided. Try to improve your self-talk and do a running commentary as each symptom happens. For example as your heart beats faster just tell yourself it's adrenaline and your body will calm down in a minute. Promote wellbeing rather than telling yourself horror health stories.

Another tool which can be of great benefit is to focus on external things rather than what’s going on inside you.

Distraction

This is a very simple but powerful technique. Again, you have to really put some work in beforehand for it to really work, and you have to stick at it when the waves of panic hit you. There are numerous ways to distract yourself. Most books will teach you things like –

- Count backwards from fifty

- Sing along to your favourite song

- Count the number of cars that go past you

- Imagine your somewhere else that you enjoy

- Reciting poetry

These can work, but for the best results you really have to be engrossed in something that will totally transform your thoughts somewhere else. One of my personal favourites is to combine relaxation techniques with imagining you’re in a place of total tranquillity, which could be a desert island, a country walk or somewhere you’ve been on holiday. The more you practice and learn to switch to this state, the more powerful it will be. If you’re in a supermarket or in a queue then it’s a good place to practice. If you’re in a middle of a meeting, driving or something that requires your attention then it's bit more difficult, but at least try and distract yourself along with practicing relaxation and other techniques. As your body learns to associate places with positive things slowly your body alarm will switch off.

The important thing is your thoughts are taken off your body or external fears and onto something which is more productive. Use whatever works for you.

Distraction does work. However it's important you're not doing something for the sake of it. It's much better to have an interest in whatever is distracting you.

Also you may have found you were distracted from suffering from a panic attack when something happened to totally snap you out of it. For example the phone ringing or somebody asked you to do something.

Remember: Distraction breaks the cycle of fear but it’s not preventing something awful that might have happened if you have not distracted yourself. The very fact that distractions works shows that a phone ringing could not prevent a heart attack. Clearly if you really were having a heart attack distraction, breathing or relaxation would not help this. So you know that none of these bad things were going to happen anyway.

Distraction develops new neural pathways in the brain so you associate places with more happy thoughts

Challenging your Thoughts

This for me is where real progress can be made. You have probably seen quick fix solutions for curing panic attacks. I have tried most of them and they don't work. Why? Magical quick fix solutions fail because there is always an underlying problem that deep down we believe these anxious thoughts even though we may be unaware of it. By questioning your thoughts you can reprogram your brain to believe more positive things. Disassemble negative thoughts and replace them more beneficial thoughts that will compliment your wellbeing.

To challenge your thoughts you have to do two basic things –

Work out what your worst fears are. Everybody’s fears are different. My personal favourite is to write down the panicky thoughts on paper as they appear. It can be quite surprising what you actually fear at the time of a panic attack as to what you thought you feared.

Challenge these thoughts and come up with more realistic thoughts and positive thoughts.

Once you identify what’s racing through your head you can ask yourself

What evidence is there for and against this?

How many times does this thought happen and have your worst fears happened?

Do your experiences fit more with anxiety or panic attacks rather than a serious disease? For example does walking around a supermarket bring on a panic attack, or is it likely a supermarket could make you faint or have a heart attack?

Just as I recommend you writing down your scary, frightening and negative thoughts when they happen, it also can be useful to write down more realistic helpful thoughts for when you need them. It sometimes very difficult to come up with these thoughts when you are panicking. You may think challenging and changing your thoughts is a total waste of time, but I can’t recommend enough that real change can be achieved doing this. Your mind is like a computer and you have been feeding all sorts of negative and terrifying programs into it. It’s now time to start re-programing it to a new sub-routine, that shifts you away from panic symptoms to promote a more well-being programme. This will then produce the feel-good chemicals that make you happy, excited and cheerful.

Below are some examples of unrealistic and unhelpful thoughts, with more realistic and positive alternatives given below.

Unhelpful/unrealistic thoughts

More realistic/positive thoughts

I will make a fool of myself

So what if I panic, no one will ever notice. People are busy getting on with their lives. Even if they do notice they will just think I’m a bit nervous.

I’m going to faint

People with panic attacks don’t faint as their bodies are being pumped with adrenaline and blood pressure rises to fight or run. Besides I have never fainted before.

I’m going mad

The feeling and thoughts are down to anxiety. They are not a sign of serious mental illness. I am healthy and I just need to take better care of myself.

I’m having chest pains

I have a tightness in my chest and I know it’s down to muscle contraction. I have felt this many times before and nothing ever bad has actually ever happened. As I learn to relax I know I will feel better.

Challenging thoughts is a great way to start changing behaviour and how our bodies react to certain situations. Often we know that it’s completely stupid that we panic in this way, but we can seemingly do nothing about it. This way panic attacks become a person's ‘secret’.

The next step, which requires a little courage, is to challenge our thoughts in the heat of the moment to alter our behaviour. But before you get this far it’s worth looking at another way your mind maybe contributing to panic attacks. Not through anxious thoughts, but because you have other issues that maybe upsetting you.

You may have on-going issues in your life which are adding to the stress of your daily life. You need to be generally around people who give you energy rather than people who take it away. It goes without saying that sometimes you cannot avoid difficult situations – That’s life. But I’m thinking of issues such as

- An abusive relationship?

- A job which you hate?

- Family members that are hindering rather than helping?

- Do you have a tendency to have regrets about the past?

- Do you feel angry or sad?

- Is something troubling you which you need to face up to?

I would suggest if you can, facing up to these difficulties and doing something about them. Talk to a friend or even a professional councillor if this helps you. It’s important you face and overcome these issues, just as you will have to with anxiety. The more you can cut out the stresses in your life, the more your body, mind and soul will calm down and the healing can begin. You have a duty to yourself not to have a ‘troubled soul’.

Behaviour

Along with challenging your thoughts and being more positive, also challenging how you act and behave can have a dramatic affect. I have shown you how avoidance and escape, keep the panic cycle alive. It makes sense now to change your safety behaviours which promotes your panicky feelings. Every time you run away you are encourage the panic feelings even more.Put simply, you need to show yourself that the situation you are most frightened of cannot harm you. Therefore if the worst case scenario is you have a panic attack – so what?

I would advocate doing it at one small step at a time, and in a planned way. Tackle something small like going down to the corner shop rather than going to some massive out of town shopping centre. So, you really have to do it little by little, and as often as you can, to prove you can do it. This way it's confidence building.

It is important to know even if you have a panic attack it will stop eventually. Usually the actual panic attack only lasts a few minutes, and then you’re left with anxiety. Give it time and your body will naturally just go back to a more balanced state.

Below are some of the most common behaviours you need to change –

Avoidance

When opportunities come along or there are things you need to do, (for example you need a sandwich from a shop with a big queue,) don’t avoid them. Before you suffered from this you probably didn’t have to think twice about standing in a queue or whatever your fears are now. So you have to go back to that way of thinking. By staying in the queue and realizing that you will not faint, go mad or die you will be creating new behavioural patterns. But remember to do this with the other tools you have gained like relaxation, distraction, challenging your thoughts, being positive, breathing, etc.

You will probably be extremely anxious doing this as you have learnt to avoid these situations before. But stick without and persevere, you will see results.

Escape

Note what situations you are trying to escape. Do you get halfway around the supermarket and then want to leave, or may-be the checkouts are the difficult thing. Do you eat half a meal then want to leave? Do you hate driving on motorways and can’t wait for the next junction to get off? By not escaping and using the techniques shown here, you will teach yourself there is nothing to fear and start learning new positive behavioural patterns. Before long you will find that you can’t have panic attacks in these situations.

Safety Behaviour

Anxiety sufferers tend to have coping techniques to limit the effects of the panic attack sensations. Do you sit down when your legs feel wobbly? Do you rush through busy crowds to get to quieter places? Do you drink alcohol to self-medicate to get through situations? You will need to stop these safety behaviours and prove to your mind that if you do stand in a crowd not drunk, you will be perfectly fine.

The best results will come from gradually exposing yourself and improving your skills in changing your behaviour. I would encourage you to burn bridges and really stay in the situation, as just testing to see how far you go will only lead to you escaping when the going gets tough.

It may be useful for you to write down what you could try, and what you found out. For example

Safety behaviour and Purpose

What you did instead

What did you learn?

Leaned on shopping trolley to prevent fainting

Walked with a basket

I did not faint without trolley

Lied down to prevent heart attack happening

Ran up and down stairs

I did not have a heart attack and after a while my symptoms faded

By slowly disproving your old fears you will find that you are much more capable then you can imagine. You will find your confidence grows and your panic attacks will become less frequent and less strong when you do have them. People who develop persistent panic attacks develop lots of phobias, it's so it’s important you rectify each one, one step at a time. Starting with the easier ones first. You find success in one area will spread to other areas.

As you can see there is no quick fix solution but if you put the hard work in you will see benefits. For me, it took a quite a few weeks/months before I saw the real benefits. I would also recommend you eat healthy and generally look after yourself. Give yourself every chance of recovery.

A Brief Summary of Coping with Panic Attacks

Practice distraction, relaxation, slow breathing and challenging your thoughts when you are not anxious so that these skills can be learnt for when you will need them.

Tell yourself panic attacks are harmless and that you have panicked on many occasions before and nothing awful has happened.

The less troubles and worries you have the better. Look at your lifestyle and see what changes you can make to have less stress.

Challenge the unrealistic thoughts you have during a panic attack. Write down fearful thoughts you have and provide model answers you can tell yourself when you need them.

Apply the tools and techniques of distraction, relaxation and breathing to counteract anxiety and panic.

Burn your bridges and don’t use escape, avoid or use safety tactics to remove yourself from fearful situations. Stand your ground and see what really happens – Nothing. The only power panic attacks have over you is the fear your giving them.

Tell me your experiences with panic and anxiety in the comment box below. Have you managed to cope or cure it? What did you find helpful?

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